Elevated Lp(a) (>=30 mg/dL) is associated with higher sarcopenia risk in 426 patients with type 2 diabetes, regardless of sex (Diabetes Metab Syndr Obes 2024)

Background: The association between lipoprotein(a) (Lp(a)) and sarcopenia in T2DM patients of general age is unclear, and whether this association differs by sex remains uncertain. We intend to analyze the association between Lp(a) and sarcopenia in patients with type 2 diabetes mellitus (T2DM) and whether this association differs by sex.

Methods: T2DM patients between December 2021 and December 2022 were consecutively enrolled. Sarcopenia was defined according to the criteria of Consensus of the Asian Working Group for Sarcopenia (AWGS) 2019.A multivariable logistic regression model was used to calculate the odds ratio of Lp(a)≥30 mg/dL for sarcopenia in total T2DM patients and in all sexes. Restricted cubic splines were also used to evaluate the association between Lp(a) and sarcopenia.

Results: Among the 426 patients, the mean age was 58.6 years and 56.3% were males. The prevalence of sarcopenia was 31.7% in total patients, 34.2% in male and 28.5% in female. The percentages of Lp(a)≥30 mg/dL were 19.0% in total patients. Compared with patients in Lp(a)<30 mg/dL group, those in Lp(a)≥30 mg/dL group showed an increased risk of sarcopenia (adjusted odds ratio [aOR]: 2.19, 95% CI: 1.09 to 4.39, p = 0.027). Results from restricted cubic splines were robust. When analyzing each sex, there was also a significant association between Lp(a)≥30 mg/dL and sarcopenia (male: aOR: 2.59, 95% CI: 1.09 to 6.21, p = 0.032; female: aOR: 2.45, 95% CI: 1.06 to 6.03, p = 0.039).

Conclusion: In T2DM patients, elevated Lp(a) was associated with an increased risk of sarcopenia and such an association did not differ by sex. Screening for sarcopenia should be emphasized in T2DM patients with Lp(a)≥30 mg/dL, both men and women.